Published · Updated · SkinWise Clinic
Melasma: recognising the pattern and managing recurrence
Melasma often causes patches of brown or grey-brown pigment on both sides of the face. It can persist, improve and return. Similar-looking patches may have other causes, so an examination is useful before buying another brightening cream or booking a laser.
Is it melasma or a mark after inflammation?
The history matters. Pigment appearing after acne, eczema, a burn or an irritating product may be post-inflammatory hyperpigmentation. Melasma has its own pattern and can be associated with hormonal influences and sunlight. Several concerns can coexist.
Note where the patches began and whether they itch, scale or have changed. A new isolated spot, bleeding or a changing lesion should be checked separately instead of being assumed to be melasma.
Why treatment can need maintenance
The 2026 international consensus describes a sustained approach using photoprotection and medical care, with selected procedures when justified. It does not support a permanent-clearance promise. Recurrence is a reason to review the plan, not a personal failure.
Your follow-up discussion can cover whether the original diagnosis still fits, whether treatment is irritating the skin, and which parts of the routine are practical to continue. Avoid restarting an old prescription indefinitely without advice.
A workable approach to sun protection
Choose a broad-spectrum sunscreen you can use consistently, alongside shade and clothing. For melasma, ask about a tint with suitable iron oxides. In a randomised trial, UV-plus-visible-light protection helped more than UV-only protection while both groups also used hydroquinone. The result does not establish sunscreen alone as a cure or prove that every tinted product performs equally.
The sunscreen guide explains labels and application. Ordinary phone and computer light should not be equated with sunlight: a systematic review did not identify device exposure as a pigmentation hazard, but noted limited evidence.
What to ask about medicines and procedures
- What diagnosis is being treated, and what improvement is realistic?
- How should I use the actual prescription, and what irritation needs contact?
- How do pregnancy, contraception or other medicines affect my choices?
- What might a peel or laser add, and what are its pigment and recovery risks?
- What should continue after improvement, and when should I return?
A review of treatments for post-inflammatory pigment also documents variable evidence and possible worsening with procedures. More treatment is not automatically better when pigment has already reacted to irritation.
For a practical consultation guide, read melasma treatment in Bengaluru. For the clinical options and booking route, visit melasma care.